CRUCIATE LIGAMENT ALLOGRAFT RECONSTRUCTIO N - CLINICAL PERSPECTIVE

There is a continuing search for the ideal substitute for the cruciate ligaments. Autogenous tissues are widely used as replacement but allo grafts are an at tractive alternative: no donor side morbidity, decrea sed operation time, smaller incisions especially with new endoscopic t echniques, unlimited supply especially for multiple ligament recontruc tions and a long shelf life are potential advantages of allografts. Th ey may be useful in circumstances where no suitable autologous substit ute is available. The use of an allograft requires appropriate donor s election and screening, careful surgical tissue procurement and safe a nd effective processing techniques. However, subclinical immun respons es and the possibility of transmission of viral infections (i.e. HIV) must be considered. The role of graft processing and secondary sterili zation of allografts are not clear. Although results in the literature and in our series are encouraging, the lack of patient safety is a ma jor drawback against allograft tissue at the present time. The authors reserve allografts presently for use in very special indications.